Surgical instrument having an articulated jaw structure and a detachable knife

ABSTRACT

A surgical instrument with articulated jaw structure includes a frame and two jaws. The jaws have proximal portions that are mounted to each other for movement in a substantially parallel relation between a fully open position wherein the jaws are separated for receiving tissue therebetween and an approximated position wherein the jaws are closer together. Preferably, the jaws are in the fully open position when the distal portion of at least of the jaws is located in an extended position and are in the approximated position when the distal portion of the extended jaw or jaws is located in a retracted position. The surgical instrument may further include a detachable knife assembly and knife actuating mechanism.

This application is a continuation of U.S. application Ser. No.08/596,938, filed Feb. 5, 1996 now U.S. Pat. No. 5,749,893, which is acontinuation of Ser. No. 08/291,331 filed Aug. 17, 1994 abandoned whichis a continuation of Ser. No. 08/055,824 filed Apr. 30, 1993 abandoned.

This invention relates generally to jaw-type surgical instruments and,in particular, to a jaw-type surgical instrument wherein the opposedjaws move substantially parallel over a significant part of theiroperating range and/or wherein one of the jaws includes a cartridgehaving a knife assembly that is detachable from its operating mechanism.

BACKGROUND OF THE INVENTION

A wide variety of surgical procedures used today involve surgicalinstrumentation having jaw structure such as grippers, graspers,dissectors, clamps, cutting elements and/or stapling elements. In eachof these types of jaw structure, selected tissue is captured by the jawsfor manipulation. One type of jaw structure currently used capturestissue by a pivotal action of the jaw structure wherein the jaws closeprogressively from a pivot point outward to the end of the jawstructure. See, for example, U.S. Pat. No. 5,040,715 to Green et al.This pivotal action, however, causes the captured tissue to be pushedaway from the jaw pivot point upon approximation, possibly resulting inuneven cutting, unintentional tissue trauma, and/or inaccurate tissuemeasurement or joining. This type of jaw structure is alsodisadvantageous in endoscopic or laparoscopic procedures wherein thesurgical instrument is inserted into the body through a cannula ortrocar because the jaws must necessarily protrude a significant distancebeyond the end of the trocar to open fully. This decreases the “maneuverroom” available to a surgeon for manipulating the device within a bodycavity.

A more accurate and a traumatic way of approximating surgical jawstructure is by parallel approximation. This approach has been describedin European Patent Application No. 92104388.1, filed Mar. 13, 1992,wherein various camming structures are described for effectingsubstantially parallel movement of first and second surgical jaws. Inone embodiment, a camming plate with diagonal camming slots is slidablymounted within a tubular frame. The camming plate is connected to amoveable jaw such that movement of the camming plate causes the moveablejaw to move into parallel approximation with a stationary jaw. Inanother embodiment, an axially slidable camming collar engages a cammingsurface on the moveable jaw to actuate the opening and closing of thejaws. Sliding the collar forward closes the jaws, whereas pulling thecollar backward opens the jaws. This design, however, creates a veryhigh frictional component to the overall opening and closing forces,affecting the overall ease of operation of the device. Additionally, inall of the embodiments described, the jaws are prevented from movingaxially, which, as will be discussed below, precludes the user fromenjoying many other advantages.

The above devices also describe jaw structures that employ a staplecartridge. Typically, the staple cartridge is provided with an axiallyextending slit through which a knife passes to cut the captured tissueat the time of stapling. An axially moveable actuating mechanism (e.g.,a pusher rod) is used to push the knife through the cartridge. Thelocation and structure of the knife actuating mechanism is well knownfor jaws having purely pivotal movement, but such is not the case forjaws that are capable of substantially parallel approximation. In thislatter situation, especially in connection with endoscopic orlaparoscopic procedures where accessibility is extremely limited,inclusion of the knife actuating mechanism can result in a reduction inthe maximum distance the jaws can open and/or result in furtherpenetration of the jaws beyond the end of the cannula into the bodycavity to accommodate the knife actuating mechanism.

It is also desirable to have a fresh knife available after eachtransection. In presently available apparatus, however, the knife hasbeen an integral part of the combined pusher rod/cartridge assembly.This design requires the pusher rod mechanism to be discarded after eachuse, causing waste, and requires that the overall length of thecartridge assembly be increased in size to account for the entireextended length of the pusher rod mechanism.

Another disadvantage of the above-described devices is that jaw closingis typically accomplished by actuating an axially movable rod operablyconnected to the jaws. Pushing on the actuating rod closes the jaws andpulling on it opens them. Using compression force on the actuating rod,however, to close the jaws around the captured tissue can result inbuckling. This could have serious consequences if buckling occurredduring a particularly sensitive part of the surgical procedure.

In view of the above, it should be appreciated that there is still aneed for a jaw-type surgical instrument wherein the jaws are heldsubstantially parallel over a significant part of their operating range,yet open widely with minimal extension of the jaws beyond the end of thecannula into the body cavity during the operating procedure. There isalso a need for a device wherein the jaws are axially moveable to effectapproximation and wherein the mechanism for closing the jaws around thecaptured tissue is without risk of instrument failure due to buckling ofthe push rod. Such a device would also preferably include an easilyreplaceable knife without significantly affecting the operation of thejaws or requiring frequent replacement of the knife actuating mechanism.The present invention satisfies these needs.

SUMMARY OF THE INVENTION

The present invention is embodied in a surgical instrument having anarticulated jaw structure, wherein a pair of jaws are held substantiallyparallel over a significant part of their operating range, yet arecapable of being held widely open with minimal extension of the jawsbeyond the end of a mounting cannula or frame during an operatingprocedure. One or both jaws are adapted to be axially moveable relativeto the frame. The surgical instrument also includes a jaw operatingmechanism that is not subject to buckling during jaw approximation. Thepresent invention is particularly adapted for use in surgical staplinginstrumentation and permits the use of a staple cartridge/knife assemblycombination that is relatively short in length and easily replaceable.

In one embodiment of the invention, the surgical instrument witharticulated jaw structure includes a tubular frame and an actuatingmechanism moveable inside the tubular frame. The actuating mechanism hasa cam that engages corresponding camming surfaces on first and secondjaws. Each of the jaws has a proximal portion defining the cammingsurface and a distal portion. The proximal portions of the jaws arepivotally mounted to each other. The distal portions of the jaws areconfigured to capture tissue between them. The cam and camming surfacesare configured such that upon movement of the cam between a firstposition and a second position, the jaws will pivot relative to eachother between an open position and an intermediate position,respectively. One of the jaws also includes a cam stop that furtherengages the cam when the cam is in the second position such that uponfurther movement of the actuating mechanism between the second positionand a third position, the jaws will retract axially into the tubularframe. One of the jaws further includes a ramp that engages a distal endof the tubular frame upon axial retraction of the jaws. The ramp isconfigured such that the jaws move in a substantially parallel relationbetween the intermediate position and an approximated position uponmovement of the cam between the second position and the third position,respectively.

A feature of this embodiment of the invention is that the jaw motion maybe broken down into two components, a primarily pivoting motion of thejaws during initial jaw closing, which does not consume significantaxial length between the distal portions of the jaws and the tubularframe and a substantially parallel approximating motion of the jaws thatdoes consume axial length as the jaws are retracted into the tubularframe. Through this construction, axial stroke is substantially limitedto the latter high force segment of the jaw closing cycle (i.e., thecompression of tissue by the approximating jaws). In turn, a shorteraxial stroke means less extension of the jaws beyond the end of thetubular frame and less protrusion into the body cavity, increasing the“maneuver room” of the surgeon manipulating the instrument.

Another feature of the present invention is that the jaw mechanism maybe operated by an actuating rod that closes the jaws upon pulling therod and opens the jaws upon pushing the rod. Using tensile force toclose the jaws reduces the likelihood that the actuating rod willbuckle. Buckling can only occur during compressive loading, which occursduring jaw opening. Since the jaw opening force is always lower than thejaw closing force, the maximum buckling force is lower than it would beif the situation were reversed.

In a second embodiment of the present invention, the surgical instrumentwith articulated jaw structure includes a frame, a fixed jaw mounted tothe frame at its proximal end and a moveable jaw. The moveable jaw isconnected to the fixed jaw to permit movement between an open positionwherein the distal ends of the jaws are spaced apart from each other andthe moveable jaw is extended distally relative to the fixed jaw, and anapproximated position wherein the distal ends of the jaws are closertogether and the moveable jaw is substantially unextended relative tothe fixed jaw. An actuating mechanism is provided for moving the jawsbetween the open and approximated positions.

A particular feature of the second embodiment of the invention is thatthe moveable jaw juts out from the fixed jaw when the jaws are open. Asthe jaws close, the moveable jaw moves back along the fixed jaw, pullingtissue back toward the proximal end of the jaws. This inhibits tissuefrom extruding out of the gap between the jaws, which is opposite to theundesirable result caused by the prior art single pivot jaws wherein thetissue is pushed out of the jaws during closing.

The present invention is also embodied in a surgical instrument havingarticulated jaw structure and a detachable knife. By including amechanism for engaging and disengaging a knife, the jaws can be heldsubstantially parallel over a significant part of their operating range,yet still open widely with minimal extension of the jaws beyond the endof their mounting cannula or frame. In addition, because the knife isdetachable, the knife may be replaced often without requiringreplacement of its actuating mechanism.

The surgical instrument with articulated jaw structure and detachableknife of the present invention includes a first jaw and a second jaw,one of the jaws having a longitudinal cartridge detachably mountedthereto. The first jaw and the second jaw are connected to one anotherto permit movement in a substantially parallel relation between an openposition, which permits capture of selected tissue between the jaws andan approximated position wherein the jaws are in close proximity to andin opposed alignment with each other. A knife assembly is providedhaving a bearing surface, a knife blade defining a cutting edge, and alatch receiver. The longitudinal cartridge slidably receives the knifeassembly such that the cutting edge of the knife blade is permitted tomove longitudinally between the jaws when the jaws are in theapproximated position. A knife actuating mechanism having a bearingsurface and a latch is provided for moving the knife assembly from afirst position at a proximal end of the cartridge to a second positionlocated distally from the proximal end of the cartridge when the knifeactuating mechanism is moved distally. The latch is received in thelatch receiver of the knife assembly for moving the knife assembly backfrom the second position to the first position when the knife actuatingmechanism is moved proximally. A further mechanism is provided fordisengaging the latch when the knife actuating mechanism moves between alatched position and an unlatched position.

An advantage of the detachable knife is that the knife actuatingmechanism may now be a component separate from the cartridge holding theknife assembly. In stapling instrumentation, in particular, this meansthat a firing mechanism for the staples no longer needs to be anintegral part of the disposable staple cartridge. Because of this, thecartridge may be made smaller. This reduction in size is particularlybeneficial for surgical instrumentation used in endoscopic andlaparoscopic procedures.

Other features and advantages of the present invention will becomeapparent from the following description of the preferred embodiments,taken in conjunction with the accompanying drawings, which illustrate,by way of example, the principals of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an exploded perspective view of a surgical instrument havingan articulated jaw structure made according to the present invention.

FIG. 2 is an assembled side view of the surgical instrument shown inFIG. 1, showing the jaws in a fully open position.

FIG. 2A is an assembled side view of the surgical instrument shown inFIG. 2 further including a schematic view of the handle portion of theinstrument;

FIG. 3 is an assembled side view of the surgical instrument shown inFIG. 1, showing the jaws in an intermediate position.

FIG. 4 is an assembled side view of the surgical instrument shown inFIG. 1, showing the jaws in an approximated position, and showing aknife assembly and a knife actuating assembly made according to thepresent invention.

FIG. 5 is an enlarged side view of the knife assembly and the knifeactuating assembly of the surgical instrument shown in FIG. 4.

FIG. 6 is a top sectional view of the surgical instrument shown in FIG.4, taken along line 6—6.

FIG. 7 is a front sectional view of the surgical instrument shown inFIG. 2, taken along line 7—7.

FIG. 8 is a front sectional view of the surgical instrument shown inFIG. 2, taken along line 8—8.

FIG. 9 is a front sectional view of the surgical instrument shown inFIG. 2, taken along line 9—9.

FIG. 10 is a front sectional view of the surgical instrument shown inFIG. 3, taken along line 10—10.

FIG. 11 is a front sectional view of the surgical instrument shown inFIG. 3, taken along line 11—11.

FIG. 12 is a front sectional view of the surgical instrument shown inFIG. 4, taken along line 12—12.

FIG. 13 is a side view of a first modified surgical instrument having anarticulated jaw structure made according to the present inventionshowing the jaws in a fully open position.

FIG. 14 is a side view of the surgical instrument shown in FIG. 13,showing the jaws in an intermediate position.

FIG. 15 is a side view of the surgical instrument shown in FIG. 13,showing the jaws in an approximated position.

FIG. 16 is a side view of a second modified surgical instrument havingan articulated jaw structure made according to the present invention,showing the jaws in a fully open position.

FIG. 17 is a side view of the surgical instrument shown in FIG. 16,showing the jaws in an intermediate position.

FIG. 18 is a side view of the surgical instrument shown in FIG. 16,showing the jaws in an approximated position.

FIG. 19 is an enlarged side view of a portion of the surgical instrumentshown in FIG. 18, and showing a knife assembly and a knife actuatingassembly made according to the present invention.

FIG. 20 is a partial perspective view of a third modified surgicalinstrument having an articulated jaw structure made according to thepresent invention.

FIG. 21 is a rear sectional view of the surgical instrument shown inFIG. 20 taken along line 21—21.

FIGS. 22A-H are enlarged sectional views of a knife assembly and a knifeactuating assembly made according to the present invention, wherein theassemblies are shown at various stages of operation in a surgicalinstrument.

FIG. 23 is a top view of the knife assembly and the knife actuatingassembly shown in FIG. 22A.

FIG. 24 is a sectional view taken along line A—A in FIG. 22C.

FIG. 25 is a sectional view taken along line B—B in FIG. 22C.

FIG. 26 is an enlarged sectional view of the knife assembly.

FIG. 27 is a side sectional view of a surgical stapler, showing thestapling and cutting of tissue between the jaws of the stapler.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

A preferred surgical instrument 10 with articulated jaw structureembodying the features of the present invention is shown in pertinentpart in FIGS. 1-12. Only the distal end of the instrument are shown. Aschematic representation of the proximal handle portion is provided inFIG. 2A, it being appreciated that the surgical instrument may beactuated using structure and techniques well known to those skilled inthe art.

The surgical instrument 10 includes a tubular frame 12, a first or upperjaw 16 and a second or lower jaw 18. In the surgical stapling apparatus,one of the jaws (in this case, the lower jaw), may include a disposablestaple cartridge 508. The tubular frame preferably includes a collar 14.Both the frame and collar are preferably made of stainless steel. Thecollar has an end portion 22 defining an opening 23 therethrough forreceiving the jaws. A pair of diametrically opposed arms 24 extendaxially from the end portion into the interior of the tubular frame.Each arm defines an axially extending slot 26. A collar pin 28 isdisposed and located by the slots 26 such that the collar pin extendstransversely across the tubular frame. The arms of the collar form arelatively tight fit against the interior surface of the tubular frame.A proximal end of the tubular frame is mounted to the handle portion ofthe surgical instrument, shown schematically in FIG. 2A by methods wellknown to those skilled in the art.

The upper jaw 16 has a proximal portion 30 received in the tubular frameand a distal portion 32 that extends out of the end portion 22 of thecollar 14. The distal portion of the upper jaw has a tissue contactingsurface 34. Similarly, the lower jaw 18 has a proximal portion 36received in the tubular frame and a distal portion 38 that extends outof the end portion 22 of the collar 14. The upper surface of thedisposable staple cartridge 508 has a tissue contacting surface 40.

The jaws are pivotally mounted to each other such that in anapproximated position (FIG. 4), the tissue contacting surfaces are inopposed relationship to each other. The proximal portion 30 of the upperjaw 16 is a longitudinally extending bar that defines a transverseopening 42 for closely receiving the collar pin 28 located by the collar14. A proximal end 44 of the upper jaw is located by a cam 46. The camis preferably a pin that is disposed parallel to the collar pin 28,transversely across the tubular frame. The cam 46 engages a lowercamming surface 48 of the proximal end of the upper jaw. The insidesurface of the tubular frame engages an upper surface 50 of the proximalend of the upper jaw such that the tubular frame, the collar pin and thecam vertically locate the upper jaw.

The proximal portion 36 of the lower jaw 18 is a pair of longitudinallyextending members 51 that are located on each side, respectively, of theproximal portion 30 of the upper jaw (see FIGS. 6 and 7). Each member 51defines a transverse opening 52 for closely receiving the collar pin 28located by collar 14. The collar pin 28 provides an axis about which thelower jaw may pivot with respect to the upper jaw (see FIGS. 6, and 8).A proximal end 54 of each member 51 of the lower jaw defines a rampedslot 56 that receives the cam 46 (see FIGS. 1, 6 and 9). The cam engagesdiagonally extending camming surfaces 58 of the ramped slots. Eachdiagonally extending camming surface extends downwardly from theproximal end of the slot to the distal end of the slot (see FIG. 3).Each of the longitudinally extending members 51 of the lower jaw, atdistal ends 60 thereof, defines a ramp 62. An upper portion 64 of eachramp is curved. Below each ramp is a shoulder 66.

The cam 46 may be fixed to a clevis 67 that is mounted to the distal endof an actuating rod 68. Preferably, the actuating rod is axiallymoveable within the tubular frame to move the cam between first, secondand third positions to be described in more detail below. A proximal end(not shown) of the actuating rod is connected to the surgical instrumentby methods known to those skilled in the art for actuation by theoperator of the instrument.

With reference now to FIGS. 2-4, the operation of the jaw structure ofthe surgical instrument will be described. FIG. 2 shows the jaws in afully open position with the cam 46 in a first position A. In the openposition, the distal portions 32, 38 of the jaws are fully extended fromthe tubular member with the curved upper portion 64 of the ramp of thelower jaw adjacent to the end portion 22 of the collar 14. The collarpin 28 is in a first position at a distal end 72 of the collar arm slots26. The cam 46 is between the lower camming surface 48 of the upper jawand a lower end 76 of the ramped slot 56, preventing counterclockwiserotation of the lower jaw about the collar pin 28.

FIG. 3 shows the jaws in an intermediate spaced position (see also FIG.11). By pulling on the actuating rod 68, the cam 46 is axially retractedfrom the first position A at the lower end 76 of the ramped slot to asecond position B at an upper end 78 of the ramped slot. During theaxial retraction, the cam 46 engages the diagonally extending cammingsurface 58 of the ramped slot to cause the lower jaw to pivot in aclockwise direction about the collar pin 28 with respect to the upperjaw. Jaw motion takes place rapidly relative to the axial movement ofthe actuating rod. Preferably, movement of the jaws from the fully openposition to the intermediate position is accomplished with little or noaxial movement of the jaws relative to the tubular member. A highclamping force between the jaws is unnecessary at this stage of theoperation because the jaws are only beginning to capture tissue betweentheir tissue contacting surfaces. Notably, in the intermediate position,the collar pin 28 is still located near the distal end 72 of the collararm slots 26 and the cam 46 still engages the lower camming surface 48of the upper jaw. Further, the lower jaw has moved into a positionwherein further axial movement of the lower jaw will cause the curvedupper portion 64 of the ramp 62 to contact a lower edge 70 of theopening 23 of the collar (see also FIGS. 1 and 10). It is theinteraction between the ramp and the collar that will cause the jaws toapproximate in a substantially parallel relation.

FIG. 4 shows the jaws in an approximated position wherein the cam 46 hasbeen pulled from the second position B to a third position C. During theaxial retraction, the cam 46 engages the upper end of the ramped slot 56which acts as a cam stop 80, forcing the lower jaw and, correspondingly,the upper jaw (through the connection at the collar pin 28) to retractaxially into the tubular frame. Axial retraction also causes the jaws toapproximate due to engagement of the ramp 62 with the lower edge 70 ofthe opening of the collar (see also FIG. 12).

During the approximating phase of operation, jaw movement takes placeslowly in relation to actuating rod movement. High clamping forces aredesired at this point due to the high force required to compress thetissue captured between the jaws. High force multiplication occurs asthe ramp 62 bears against the lower edge of the opening of the collar14. Notably, in the approximated position, the collar pin 28 has movedto a proximal end 82 of the collar arm slots 26 and the jaws are fullyretracted into the collar, with the collar contacting the shoulder 66 onthe lower jaw adjacent the lower end of the ramp 62.

It will be appreciated that the above described construction enables thejaws of the instrument to open widely with relatively little extensionof the jaws beyond the end portion 22 of the collar 14 (as shown by thevertically oriented dashed line L at the left end of FIGS. 2-4). Thisresult is achieved by dividing the jaw closure action into two parts: afirst part, wherein the actuating rod moves the cam from position A toposition B, which requires very little, if any, axial movement of thejaws and, a second part, wherein the actuating rod moves the cam fromposition B to position C, which does require axial movement of the jaws.Notably, the second part of the jaw closure action is limited to thesegment where high forces are required to compress the captured tissuebetween the jaws. It will also be appreciated that the jaws are heldsubstantially parallel over a significant portion of their operatingrange, and, in particular, between their intermediate and approximatedpositions.

In the preferred embodiment, the ramped slots 56 of the lower jaw have atriangular or a quadrilateral shape. This permits the lower jaw to movevertically or to rotate relative to the cam 46, without requiringactuation of the actuating rod by the operator.

With reference now to FIGS. 13-15, a first modified embodiment 100 ofthe surgical instrument is shown having a tubular frame 102, anactuating rod 104, an upper jaw 106 and a lower jaw 108. In thisembodiment, the collar has been omitted and an elongated clevis 112 hasbeen fixed to the distal end of the actuating rod 104. The clevis has adistal portion 114 and a proximal portion 116. The distal portion 114defines an axially extending slot 118 for locating a clevis pin 128 suchthat the clevis pin extends transversely across the tubular frame 102. Acam 110, in the form of a pin, is fixably mounted to the proximalportion 116 of the clevis such that it is disposed parallel to theclevis pin 128 and transversely across the tubular frame.

The upper jaw 106 has a proximal portion 130 received in the tubularframe 102 and a distal portion 132 that extends out of a distal end 120of the tubular frame. The distal portion of the upper jaw has a tissuecontacting surface 134. Similarly, the lower jaw 108 has a proximalportion 136 received in the tubular frame and a distal portion 138 thatextends out from the distal end of the tubular frame. The distal portionof the lower jaw has a tissue contacting surface 140.

The jaws are pivotally mounted to each other such that in anapproximated position (FIG. 15), the tissue contacting surfaces are inopposed relationship to each other. The proximal portion 130 of theupper jaw 106 is a longitudinally extending bar that defines a traverseopening 142 for closely receiving the clevis pin 128. A proximal end 144of the upper jaw defines an axially extending slot 146 that receives thecam 110. The slot 146 is horizontally disposed in FIGS. 13-15.

The proximal portion 136 of the lower jaw 108 is a pair oflongitudinally extending members 151 that are located on each side,respectively, of the proximal portion 130 of the upper jaw. Eachlongitudinally extending member 151 defines a transverse opening 152 forclosely receiving the clevis pin 128. The clevis pin 128 provides anaxis about which the lower jaw may pivot with respect to the upper jaw.A proximal end 154 of each member 151 of the lower jaw defines a rampedslot 156 that receives the cam 110. The cam engages camming surfaces 158of the ramp slots. In FIG. 13, the camming surface extends downwardlyfrom the proximal end of the slot to the distal end of the slot. Each ofthe members 151 of the lower jaw also defines a ramp 162 at a distal end160 thereof. An upper portion 164 of each ramp is curved. Below eachramp is a shoulder 166.

FIG. 13 show the jaws in a fully open position with the cam 110 in afirst position A and the distal portions 132, 138 of the jaws fullyextended from end 120 of the tubular frame 102. The cam 110 is at adistal end 122 of the upper jaw slot 146 and at a distal end 124 of theramped slot of the lower law 156, preventing counterclockwise rotationof the lower jaw about the clevis pin 128. The clevis pin 128 is in afirst position at a proximal end 126 of the clevis slot 118. Uppersurfaces on the proximal portions of both jaws may be configured tocontact the interior surface of the tubular frame.

FIG. 14 shows the jaws in an intermediate spaced position wherein the,cam 110 has been pulled from the first position A at the distal end 124of the ramped slot 156 of the lower jaw to a second position B at aproximal end 131 of the ramped slot. During the axially retraction, thecam 110 engages the camming surface 158 of the ramped slot to cause thelower jaw to pivot about the clevis pin 128 in a clockwise directionwith respect to the upper jaw. Notably, in the intermediate position,the clevis pin 128 is now located at a distal end 127 of the clevis slot118 and the cam 110 is located at a proximal end 133 of the upper jawslot 146, it being appreciated that the upper and lower jaw slots arenow horizontally aligned.

FIG. 15 shows the jaws in an approximated position wherein the cam 110has been pulled from the second position B to the third position C.During the axial retraction, the cam engages both slot ends of the upperand lower jaw slots, the slot ends acting as a cam stop 168, forcing thejaws to retract axially into the tubular frame. Axial retraction furthercauses the jaws to approximate due to engagement of the ramp 162 withthe end 120 of the tubular frame. The lower jaw may also be permitted torotate about the cam 110 during retraction. Notably, in the approximatedposition, the clevis pin 128 is still located at the distal end 127 ofthe clevis slot 118. It will be appreciated that the operation andbenefits of the present embodiment are generally similar to that of thepreviously described embodiment.

With reference now to FIGS. 16-18, a second modified embodiment 200 ofthe present invention is shown wherein only one of the jaws is axiallymovable. The surgical instrument includes a frame member 212, an upperjaw 216 and a U-shaped lower jaw 218. The upper jaw has a proximalportion 230 fixably mounted to the frame member and a distal portion 232having a tissue contacting surface 234. The lower jaw 218 has a proximalportion 236 mounted to the upper jaw and a distal portion 238 having atissue contacting surface 240. The jaws are pivotally mounted to eachother such that in an approximated position (FIG. 18), the tissuecontacting surfaces of the jaws are in opposed relationship to eachother.

The proximal portion 230 of the upper jaw includes an articulatingmechanism for opening and closing the jaws. In particular, the proximalportion defines three pins arranged parallel to each other and whichprotrude transversely from each side of the upper jaw, a first pin 220,a cam pin 222 and a pivot pin 224. A link 228 is pivotally mounted tothe pivot pin 224 on each side of the upper jaw. As the link on eachside of the jaw is identical, only one will be described. A distal end242 of the link is provided with a link pin 226 that is parallel to theother pins and extends outwardly from the link. It will be appreciatedthat there is a space between the links for receiving a knife actuatingassembly, as more fully described in connection with FIG. 19.

The proximal portion 236 of the lower jaw has an articulating mechanismthat corresponds to the articulating mechanism of the upper jaw. In thepreferred embodiment, both upstanding walls of the U-shaped lower jawhave identical corresponding articulating structure at the proximalportions, namely, a first slot 244 for receiving the first pin 220 ofthe upper jaw and a second slot 246 for receiving the link pin 226located at the distal end of the link 228. The first slot 244 extendsdiagonally downward from a proximal end 248 to a distal end 250. Thesecond slot 246 has two portions, a proximal portion 252 having a mildslope relative to the longitudinal axis of the lower jaw and a distalportion 254 having a steep slope that is preferably disposed at an anglegreater than 90° relative to the longitudinal axis of the lower jaw. Theproximal portion of the lower jaw further includes a cam surface 256 forengaging the cam pin 222 of the upper jaw. The cam surface extendsdiagonally upward towards the proximal end of the lower jaw.

The distal ends of the links 228 may be mounted to a clevis 266 of anactuating rod 268 which is axially movable. Preferably, the clevis ispivotally mounted to the actuating rod about a traverse axis parallel tothe pins 220, 222, 224, 226. A proximal end (not shown) of the actuatingrod is connected to the surgical instrument by methods known to thoseskilled in the art for actuation by the operator of the instrument. Thelink pin 226 is movable between first, second and third positions to bedescribed below in more detail.

The operation of the jaw structure of the second modified embodimentwill now be described. FIG. 16 shows the jaws in a fully open positionwith the link pin 226 in a first position A and the lower jaw extendeddistally relative to the upper jaw. The first pin 220 is in a firstposition at the proximal end 248 of the first slot 244 whereas the linkpin 226 is at an upper end 260 of the distal portion 254 of the secondslot. The cam pin 222 is at an upper end 270 of the cam surface 256.

FIG. 17 shows the jaws in an intermediate spaced position wherein thelink pin 226 has been pulled by the actuating rod from the firstposition A to a second position B. During the axial retraction, the link228 rotates in a counterclockwise direction causing the link pin 226 toride down the distal portion 254 of the second slot, pulling the lowerjaw proximally. It is this axial linear motion of the lower jaw thatpulls tissue into the gap between the jaws and inhibits tissue fromextruding out of the gap during approximation. In addition to the axialmotion, the lower jaw also draws closer to the upper jaw due to itsrotation about the link pin 226 as the first pin 220 slides from a firstposition at the proximal end 248 of the first slot to a second positionnear the distal end 250 of the first slot. Jaw motion from the openposition to the intermediate position takes place rapidly relative toactuating rod movement. A high clamping force is unnecessary at thisstage of the operation because the jaws are only beginning to capturetissue. Notably, in the intermediate position, the cam pin 222 is at alower end 272 of the cam surface 256.

FIG. 18 shows the jaws in an approximated position wherein the link pin226 has been pulled by the actuating rod from the second position B to athird position C. During the axial retraction, the link pin 226 rides upthe proximal portion 252 of the second slot, causing the lower jaw toclose further as it rotates about the first pin 220. During this phaseof the operation, jaw motion takes place slowly in relation to actuatingrod movement. High clamping force is desired due to the high forcerequired to compress the captured tissue between the jaws. Notably, inthe approximated position, the first pin 220 moves to the distal end 250of the first slot and the cam pin 222 remains at the lower end 272 ofthe cam surface 256.

It will be appreciated that the cam pin 222 is particularly useful forreopening the jaw structure. In moving from the approximated position tothe intermediate position, the cam pin 222 will engage the cam surface256 to urge the lower jaw to its fully open, extended position. On theother hand, a biasing mechanism, such as a spring 274, may be connectedbetween the proximal portion 236 of the lower jaw and the frame 212 tourge the lower jaw from its fully open position to the intermediateposition (see FIG. 16).

As with the previously described embodiments, the second modifiedembodiment enables the jaws of the instrument to open widely withrelatively little extension of the jaws beyond the end of the frame.Furthermore, the jaws are held substantially parallel over a significantportion of their opening range and, in particular, between theirintermediate and approximated positions.

With reference to FIGS. 20 and 21, a third modified embodiment 300 ofthe present invention is shown. As with the second modified embodiment,an upper jaw 310 has a proximal portion 312 that includes anarticulating mechanism for operating the jaws. The proximal portionincludes a collar 314 defining a longitudinally extending opening 316 atthe center thereof. A first pin 320 is mounted to the collartransversely across the longitudinally extending opening 316. A cam pin322, parallel to the first pin 320, extends outwardly from each side ofthe collar. A pivot pin 324, parallel to the first pin and the cam pin,extends outwardly from each side of the proximal portion of the upperjaw, adjacent the collar. A link 328 is pivotally mounted to each sideof the upper jaw at the pivot pin 324. A distal end 329 of each link isprovided with a link pin 326 that is parallel to the other pins andextends outwardly from its respective link.

A U-shaped lower jaw 330 includes a base wall 332 and two upwardlyextending side walls 334. In addition, the lower jaw is provided with aninterior cam plate 336 that is disposed in the longitudinally extendingopening 316 of the upper jaw. A mounting block or blocks 350 may be usedto mount the cam plate 336 to the upwardly extending side wall(s) of thelower jaw. The mounting blocks may be placed between the sides of thecam plate and each of the upwardly extending walls, just below the lowersurface of the upper jaw. As in the second modified embodiment, a firstslot 338 is provided for engaging the first pin 320, a second slot 340is provided for engaging the link pin 326 and a cam surface 342 isprovided for engaging the cam pin 322. In this instance, however, thefirst slot 338 is disposed in the interior cam plate. 336 of the lowerjaw, not in the upwardly extending walls. In this regard, it willappreciated that the operation of the jaws of the third embodiment,between the fully opened, the intermediate and the approximatedpositions is similar to that fully described in connection with thesecond modified embodiment and need not be further described.

With reference now to FIGS. 1 and 4, the surgical instrument, in thiscase, a surgical stapling apparatus, is shown having a knife assembly510 mounted in the disposable staple cartridge 508 for longitudinallyslidable movement therein. The construction of the staple cartridge andthe techniques for operating the stapling mechanism are well known tothose skilled in the art. Briefly, however, the staple cartridge istypically a longitudinally extending member that is detachably mountedwithin the U-shaped lower jaw 18 of the surgical instrument. The staplecartridge includes a longitudinal slit 514 and a number of slots 516arranged on both sides of the slit and adapted to accommodate staples518 and staple pushers 520 (see also FIG. 27). The upper jaw or anviljaw 16 of the surgical stapler typically includes a longitudinal slit(not shown) aligned with the slit 514 of the staple cartridge when thejaws are in the approximated position and also includes a plurality ofrows of depressions 523 aligned with the staple slots 516 for bendingthe staples fired from the staple cartridge. To eject the staples, aplurality of pusher rods 524, pointed at their distal ends 526 areinserted through additional slits 528 in the proximal end of the staplecartridge,(see FIGS. 23 and 24) to slide longitudinally therein. Thepusher rods contact the pushers 520, causing the pushers to rise andexpelling the staples 518 out of their slots (FIG. 27). Tissue 529captured between the jaws is thus stapled and cut.

With reference now to FIGS. 22A-H, the knife assembly 510 is shownmounted in the staple cartridge. The knife assembly includes alongitudinally extending knife support 530 having a proximal end 532 anda distal end 534 and a knife blade 536 defining a cutting edge 538. Theknife blade extends upwardly from the support with its cutting edgefacing distally. With reference to FIG. 26, the knife blade includes anintegral base 540 that may be seated in a notched area 542 at the bottomof the knife support with the cutting edge of the blade protrudingthrough an opening 544 at the top of the knife support.

The proximal end 532 of the knife support includes a pair of latchreceivers 546 extending transversely from each side of the knifesupport. Each latch receiver may be configured as a trapezoid having aproximally located, upwardly extending, ramp 548 and a distally located,downwardly extending, ramp 550.

The knife assembly is received in a longitudinally extending opening ofthe staple cartridge, with the knife blade extending upwardly throughthe longitudinal slit 514 of the staple cartridge. The knife blade isinitially disposed in a protective shield 551 at the proximal end of thestaple cartridge. The bottom of the staple cartridge includes a recessedportion 553 and a trough portion 554 for receiving the knife support 530of the knife assembly (See FIG. 24). The recessed portion 553 closelyreceives the knife support, whereas the trough portion 554 defines atunnel 552 on each side of the knife support, the purpose of which willbe described in more detail below in connection with the operation ofthe knife actuating assembly. The additional slits 528 shown in FIG. 24are for receiving the pusher rods 524 previously described.

A knife actuating assembly 512 for moving the knife is also shown inFIGS. 22A-H. The knife actuating assembly includes a base 556, a bladesupport 558 and two latch assemblies 560. The blade support ispreferably a metal blade that is fixedly centered on the top of the baseand disposed in a longitudinal direction. The latch assemblies eachinclude a flexible latch arm 562 having a proximal end 564 and a distalend 566. A latch 568 is disposed at the distal end of each latch arm.The proximal ends of the latch arms are fixedly mounted within a recess570 at the bottom of the base. The recess includes a beveled portion 572at the distal end of the base to permit the latch arms to deflectupwardly. The proximal end (not shown) of the knife actuating assemblyis connected to the surgical instrument by methods known to thoseskilled in the art for actuation by the operator of the instrument. Theknife actuating assembly is movable between a first latched position, asecond latched and an unlatched position, as will be described in moredetail below.

Preferably, the pusher rods 524 are also mounted to the knife actuatingassembly to ensure that the pusher rods and the knife blade 536 movesimultaneously in a predetermined manner through the staple cartridgeduring the stapling/cutting procedure. With reference to FIGS. 4 and 5,the knife assembly 510 and the knife actuating assembly 512 are shownlocated in the first embodiment of the invention. The staple cartridgeand knife assembly 510 form an integral disposable part that is locatedin the distal portion of the lower jaw (see FIG. 1). The knife actuatingassembly is located in the tubular frame 12 between the longitudinallyextending members 51 of the lower jaw. The blade support 558 and pusherrods 524 are located below the proximal portion 30 of the upper jaw.Alternatively, the proximal portion of the upper jaw may be configuredto permit free movement of the blade support and pusher rodslongitudinally through the tubular frame. Notably, when the jaws are inthe fully open and intermediate positions, the knife assembly typicallycannot be operated because it is out of alignment with the knifeactuating assembly. In the approximated position (FIGS. 4 and 5), theknife assembly and knife actuating assembly are aligned. In thisposition, the staple cartridge is ready to be fired and the knife isready to be actuated to cut through tissue captured between the jaws.

With reference to FIG. 19, the second modified embodiment is similarlyshown having the knife assembly 510 and knife actuating assembly 512located in the surgical instrument. The knife assembly is located in thedistal portion 238 of the lower jaw and the knife actuating assembly islocated at the bottom of the proximal portion 236 of the lower jawbetween the links 228. The blade support 558 and pusher rods 524 arelocated below the proximal portion 230 of the upper jaw. As with thefirst embodiment shown in FIG. 5, the knife assembly typically cannot beoperated when the jaws are in the open and intermediate positions (FIGS.16 and 17), but is operable in the approximated position (FIG. 18).

With reference now to FIG. 23, the knife actuating assembly 512 is showninitially engaged to the knife assembly 510 and staple cartridge 508. Inparticular, the pusher rods 524 are located by the slits 528, which havebeveled outer edges 574 to facilitate entry. The blade support 558 islocated by a shallow slit 576 formed into the upper surface of the knifesupport 530 (See also FIGS. 24 and 26). The shallow slit may also bebeveled to facility entry of the blade support.

With reference now to FIGS. 22A-22H the operation of the knife actuatingassembly will be described. FIG. 22A shows the knife actuating assemblyin an unlatched position wherein the latch 568 and the blade support 558are out of contact with the staple cartridge 508 and knife assembly 510.FIG. 22B shows a prelatched position, with the knife actuating assemblymoved from right to left as shown by the arrow. The blade support 558 islocated in the shallow slit 576 at the top of the knife support 530 andthe latch receiver 546 has deflected the latch 568 upwardly as the latchrides up the ramp 548. Notably, the knife assembly has not moved forwardyet, despite the horizontal component of force applied by the latch tothe latch receiver, because a detent 578 integral with the bottom of thecartridge offers adequate resistance to forward motion at this point.FIG. 22C shows a first latched position at the proximal end of thecartridge, wherein the latch has dropped behind the latch receiver (seealso FIG. 25 showing the latch arms 562 disposed over the latchreceivers 546).

FIG. 22D shows the knife actuating assembly in a firing position,wherein a bearing surface 580 of the base 556 contacts a bearing surface582 at the proximal end 532 of the knife assembly and starts pushing theknife assembly forward, overcoming the resistance of the detent.Notably, the blade support 558 does not quite contact the back surfaceof the knife blade 536, its purpose being to act as a support in casethe resistance to cutting is so great that the knife assembly tends totilt backwards. It should also be appreciated, that the latches 568 ofthe knife actuating assembly are engaged in the tunnels 552 located oneach side of the knife support 530 of the knife assembly, at the bottomof the cartridge (see FIG. 24). The location of the latches in thetunnels becomes important when it is time to withdraw the knife, becausea roof 584 of each tunnel will ensure that the latches cannot disengagefrom the latch receivers until the knife is fully retracted.

FIG. 22E shows the knife assembly in a second latched position whereinthe knife actuating assembly withdraws the knife assembly from left toright as shown by the arrow. In this position, the latch 568 engages thedistally located ramp 550 of the latch receiver 546. The roof 584 of thetunnel 552 prevents removal of the latch, thus the latch is able to pullthe knife assembly through the longitudinal slit. FIG. 22F shows astopped position wherein the knife actuating assembly has pulled theknife assembly back as far as it will go. A rib 586, formed as anintegral part of the cartridge, does not allow the knife blade 536 toretract any further. FIG. 22G is a disengaged position wherein the latchreceiver 546 has deflected the latch 568 upwardly as the latch rides upthe distally located ramp 550. Notably, the proximal end 532 of theknife support 530 has emerged from the tunnels 552 at this point (seealso FIG. 23) and the latch 568 is free to deflect upwardly. Since theknife assembly is held in position by the rib 586, the knife actuatingassembly continues to move backwards (left to right) and disengages fromthe knife assembly which remains in the cartridge, as shown in FIG. 22H.

It will be appreciated from the foregoing description that the presentinvention describes a knife assembly that is an integral part of thedisposable staple cartridge and also describes a reusable knifeactuating assembly which stays with the reusable instrument. The knifeactuating assembly includes a latch that is captured by a latch receiverin the knife assembly. As the knife actuating assembly moves forward, itbears against with the knife assembly and moves the knife forward to cutthe tissue captured between the jaws. The knife assembly stays engagedto the knife actuating assembly as the latter is retracted until theknife assembly reaches its starting position, at which point the twoassemblies unlatch and the knife actuating assembly is free to befurther retracted out of the disposable staple cartridge.

The present invention eliminates the need for a rigid connection betweenthe knife and its actuating mechanism. This permits the cartridge jaw tobe articulated near the point where the knife connects with itsactuating mechanism. Articulation at this location frees the jaw fromsimply rotating about a single pivot point and offers an opportunity toimplement near-parallel jaw closure. The invention is particularlysuitable in endoscopic or laparoscopic procedures wherein it is desiredthat the jaws open widely in an essentially parallel relationship whileat the same time extending minimally beyond the end of the tubular frameof the surgical instrument.

Optionally, any of the devices described he rein may include a blockingbody as described in copending U.S. patent application Ser. No.08/055,817, now U.S. Pat. No. 5,447,265, attorney reference no.:49658USA4A, entitled, “Laparoscopic Surgical Instrument With a MechanismFor Preventing Its Entry Into the Abdominal Cavity Once It Is Depletedand Removed From the Abdominal Cavity”, filed in the name of inventorsClaude A. Vidal, Alan K. Plyley and Russel J. Redmond on Apr. 30, 1993.The entire contents of that application are herein expresslyincorporated by reference.

It will, of course, be understood that modifications to the presentlypreferred embodiment will be apparent to those skilled in the art.Consequently, the scope of the present invention should not be limitedby the particular embodiments discussed above, but should be definedonly by the claims set forth below and equivalents thereof.

We claim:
 1. A surgical instrument with articulated jaw structure forcapturing tissue of a body, the surgical instrument comprising: a framehaving a proximal end and a distal end, said frame defining an axialdirection; a first jaw having a proximal portion and a distal portion,the distal portion of the first jaw extending from the distal end of theframe; a second jaw having a proximal portion and a distal portion, thedistal portion of the second jaw extending from the distal end of theframe; one of said first and second jaws having a staple cartridge forholding a plurality of staples adapted to be inserted in the tissue; theproximal portions of the first and second jaws mounted to each other formovement in a substantially parallel relation at least partially duringmovement between a fully open position wherein the distal portions ofthe jaws are separated for receiving tissue therebetween and anapproximated position wherein the distal portions of the jaws are closertogether for capturing said tissue, the jaws being in the fully openposition when at least one of the jaws is moved distally with respect tothe frame and being in the approximated position when at least one ofthe jaws is moved proximally with respect to the frame; and an actuatingmechanism including an actuating rod positioned within the frame, theactuating rod being connected to at least one of the jaws and beingmovable to move the jaws between the open and approximated positions. 2.The surgical instrument of claim 1 wherein the first jaw is fixedrelative to the frame and the second jaw is movable between the extendedand retracted positions.
 3. The surgical instrument of claim 2 whereinthe proximal portion of the first jaw includes a first pin and a firstlink for mounting the proximal portion of the first jaw to the proximalportion of the second jaw, the link having a first end and a second end,the first end pivotally mounted to the proximal portion of the first jawand the second end having a link pin, the first pin and the link pinreceived in a first slot and a second slot, respectively, of theproximal portion of the second jaw.
 4. The surgical instrument of claim3 wherein the first slot is located distally of the second slot.
 5. Thesurgical instrument of claim 4 wherein the first slot extends proximallytoward the first jaw and wherein the second slot has a proximal portionand a distal portion that form a tilted L-shape, the proximal portionextending proximally towards the first jaw and the distal portionextending distally towards the first jaw.
 6. The surgical instrument ofclaim 2 further comprising a cam means for urging the jaws to theirfully open position.
 7. The surgical instrument of claim 2 furthercomprising a biasing means for urging the jaws to their approximatedposition.
 8. The surgical instrument of claim 1 wherein both jaws aremoveable between the extended and retracted positions.
 9. A surgicalinstrument of claim 8 wherein the frame is a tubular frame and theproximal portions of the jaws are pivotally mounted to each other withinthe tubular frame about a pivot pin mounted transversely within thetubular frame.
 10. The surgical instrument of claim 9 wherein themovement of the jaws is in two parts, a first part wherein the jawspivot relative to each other between the fully open position and anintermediate position and a second part wherein the jaws move insubstantially parallel relation between the intermediate andapproximated positions, said jaws being axially moveable within thetabular frame by the actuating mechanism during the second part of thejaw movement.
 11. The surgical instrument of claim 1 further comprisinga knife assembly having a knife blade defining a cutting edge, one ofsaid jaws defining a longitudinal slit for receiving the knife assemblysuch that the cutting edge of the knife blade is permitted movelongitudinally in the slit when the jaws are in the approximatedposition.
 12. A surgical instrument with articulated jaw structure forcapturing tissue of a body, the surgical instrument comprising: a framehaving an outer end; a first jaw having a proximal portion and a distalportion, the distal portion of the first jaw extending from the outerend of the frame; a second jaw having a proximal portion and a distalportion, the distal portion of the second jaw extending from the outerend of the frame; one of said first and second jaws adapted to receive astaple cartridge for holding a plurality of staples adapted to beinserted in the tissue; the proximal portions of the first and secondjaws mounted to each other for movement in a substantially parallelrelation at least partially during movement between a fully openposition wherein the distal portions of the jaws are separated forreceiving tissue therebetween and an approximated position wherein thedistal portions of the jaws are closer together for capturing saidtissue; at least one of said jaws being further moveable between anextended position when the at least one of said jaws is moved distallywith respect to the frame and the jaws are in one of the fully open andapproximated positions, and a retracted position when at least one ofsaid jaws is moved proximally with respect to the frame and the jaws arein the other of the fully open and approximated positions; and anactuating mechanism connected to the at least one of said jaws beingfurther movable, the actuating mechanism and the at least one of saidjaws being axially movable to move the jaws between the open andapproximated positions.
 13. A endoscopic surgical instrument witharticulated jaw structure, the surgical instrument comprising: a handleportion; an elongated endoscopic body portion extending distally fromthe handle portion and defining a longitudinal axis, the body portionbeing axially fixed with respect to the handle portion; first and secondjaw members connected to each other for movement between open and closedpositions, and extending from a distal end of the elongated bodyportion, the first jaw member having a staple cartridge; an actuatingmember connected to one of the first and second jaw members, theactuating member being movable to move at least one of the first andsecond jaw members axially to move the jaw members between the open andclosed positions; and wherein the jaw members are in the open positionwhen the at least one of the jaw members and the actuating member aremoved distally with respect to the elongated body portion and the jawmembers are in the closed position when at least one of the jaw membersand the actuating member are moved proximally with respect to theelongated body portion.
 14. An endoscopic surgical instrumentcomprising: a handle portion; an endoscopic body portion fixed relativeto the handle portion and defining a longitudinal axis; and a pair ofjuxtaposed jaw members remotely actuable from the handle portion andmounted for reciprocal longitudinal movement relative to the bodyportion and the handle portion between a first position wherein the jawsare in spaced relation and a second position wherein the jaws are inclose relation, one of said jaw members being adapted to receive astaple cartridge for supporting a plurality of staples.
 15. The surgicalinstrument of claim 14, further comprising a staple cartridge disposedin the one of the jaw members, an anvil surface formed in the other ofthe jaw members and a firing mechanism actuable from the handle portionfor firing the staples.
 16. The surgical instrument of claim 15, whereinthe firing mechanism fires the staples sequentially.
 17. The surgicalinstrument of claim 14, further comprising a knife assembly mounted forlongitudinal movement with respect to the staple cartridge.
 18. Asurgical instrument comprising: a handle portion; a body portion fixedto the handle portion and defining a longitudinal axis; a tool portionremotely actuable from the handle portion, the tool portion having ananvil jaw and a cartridge jaw containing a cartridge with staples, thecartridge jaw being mounted for reciprocal longitudinal movementrelative to the body portion and handle portion between a first positionwherein the jaws are in a closed position and a second position whereinthe jaw members are in an open position; an actuating mechanismconnected to the cartridge jaw, the actuating mechanism being movable tomove the jaws between the open and the closed positions; and a firingmechanism actuable from the handle portion to fire the staples from thecartridge jaw when the jaws are in the closed position.
 19. The surgicalinstrument of claim 18, wherein the cartridge is e cartridge jaw.
 20. Anendoscopic surgical instrument comprising: an elongated body portiondefining a longitudinal axis; a distal tool portion having first andsecond jaw members and extending from a distal end of the elongated bodyportion, a proximal end of at least one of the jaw members having atleast one camming slot, a distal end of one of the jaw members having astaple supply; an actuating portion having at least one bearing postslidably engageable by the at least one camming slot, the actuatingportion being longitudinally movable with respect to the elongated bodyportion to effect longitudinal movement of at least one of the jawmembers with respect to the elongated body portion; and wherein the jawmembers open and close in response to the longitudinal movement.
 21. Ina surgical instrument configured for capturing tissue, the surgicalinstrument including an elongated body portion extending distally from ahandle portion and a distal tool portion supported by the elongated bodyportion and having a staple supply, the improvement comprising thedistal tool portion having first and second jaw members extending from adistal end of the elongated body portion, one of the jaw members beingadaptable to receive a staple cartridge, and an actuating portionconnected to at least one of the jaw members and being longitudinallymovable to cause longitudinal movement of the at least one jaw memberwith respect to the elongated body portion, wherein the jaw members openand close in response to the longitudinal movement.
 22. An endoscopicsurgical instrument comprising: a handle portion; an endoscopic bodyportion fixed to the handle portion and defining a longitudinal axis; anactuation assembly disposed at least partially in the body portion andactuable by the handle portion; and a pair of juxtaposed jaw membersconnected to the actuation assembly and remotely actuable by theactuation assembly from the handle portion to move at least one of thejaw members longitudinally with respect to the body portion and thehandle portion to sequentially move the jaw members to a firstpredetermined degree of approximation and subsequently to a secondprogressive predetermined degree of approximation, one of said jawmembers being adapted to receive a staple cartridge for holding aplurality of staples.
 23. The surgical instrument of claim 22, whereinsaid actuation assembly includes at least two substantiallylongitudinally aligned camming slots.
 24. The surgical instrument ofclaim 22, wherein the actuation assembly sequentially pivots the jawsinto substantially parallel alignment with the longitudinal axis. 25.The surgical instrument of claim 24, wherein subsequent to the pivotalmovement, the jaws are moved into parallel closure by the actuationassembly.
 26. The surgical instrument of claim 22, wherein the jawmembers are mounted for reciprocal longitudinal movement relative to thebody portion.
 27. The surgical instrument of claim 22, wherein the jawmembers include an anvil jaw.